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Organization

EDWARD GWIN M.D., LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDWARD GWIN M.D. (OWNER)
(417) 883-0487
Entity
Organization

Contact information

Practice address
1342 E PRIMROSE ST, SPRINGFIELD, MO 65804-4279
(417) 886-2747
(417) 886-2774
Mailing address
2527 E MELBOURNE RD, SPRINGFIELD, MO 65804-5208

Taxonomy

Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
R5222
MO
261Q00000X
Clinic/Center
R5222
MO

Other

Enumeration date
11/12/2007
Last updated
11/12/2007
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